EP2672919B1 - Method for producing at least one patient-specific modular bracket - Google Patents

Description

The invention relates to a method for producing at least one patient-specific, modularly constructed bracket.

For the orthodontic treatment of patients with fixed brackets, brackets are glued to the patient's teeth to be treated and connected by an arch wire, so that they form an arrangement of brackets, each with a slot through which an arch wire can be guided. The brackets have a support (pad) for connection to the tooth and a bracket body which receives the wire arch in particular in a slot.

Standard brackets can be used as brackets, which are standardized according to certain standard values and can therefore be used for a certain range of patients.

But there is also the possibility of having brackets made individually for patients, such as in EP1474064B1 , EP07111572A1 , US20020010568A1 and EP08103240 disclosed.

The EP 1 941 842 A2 describes the production of a bracket, in which a computer model for a bracket with a support on a three-dimensional model of the teeth is first generated, the three-dimensional shape of the support being generated in accordance with the tooth shape and this virtual support being connected to a virtual bracket body. The three-dimensional computer model of the complete bracket is then produced

While the production of standard brackets is not difficult, the production of fully individualized brackets is very complex. In a variant, individual bracket components are available in a computer, such as, for example, a hook, wing, slot and pad, which are then combined to form a virtual bracket, this in a virtual A patient's set of teeth is set. The virtual bracket generated in this way is transmitted to a 3D printer in order to produce a real bracket.

Standard brackets are perceived as disadvantageous in that they have no individualization for a particular patient. In the case of fully individualized brackets, the time-consuming production is felt to be disadvantageous.

The object of the present invention is therefore to produce a patient-specific bracket in a simple manner.

General description of the invention

The object is achieved by a method having the features of claim 1.

• 1a) Bereitstellen einer Rohauflagenbibliothek mit Rohauflagen,
• 1b) Bereitstellen mindestens einer Bracketkörperbibliothek von Bracketkörpern,
• 1c) Herstellen eines patientenspezifischen Modells der Dentition (Set-Ups), insbesondere aus Gips, von zu behandelnden Zähnen eines Oberkiefers und/oder eines Unterkiefers eines Patienten,
• 1d) Auswählen einer Rohauflage aus der Rohauflagenbibliothek für jeden zu behandelnden Zahn des Patienten,
• 1e) Bilden einer patientenspezifischen Klebefläche an jeder Rohauflage zur Herstellung einer Auflage mit patientenspezifischer Oberfläche, insbesondere durch Anordnen der Rohauflage in einem Abstand zum Modell der Dentition und Ausfüllen des Spalts, der sich über den Abstand erstreckt, mit Füllmaterial und Aushärten des Füllmaterials,
• 1f) Auswählen eines Bracketkörpers aus der Bracketkörperbibliothek für jede Auflage zum Verbinden jeweils eines Bracketkörpers mit einer Auflage
• 1g) Verbinden je einer Auflage mit dem zugehörigen Bracketkörper zur Herstellung eines Brackets für jeden zu behandelnden Zahn des Patienten.

The method relates in particular to the production of a patient-specific, modularly constructed bracket with a support and a bracket body

• 1a) provision of a raw edition library with raw editions,
• 1b) providing at least one bracket body library of bracket bodies,
• 1c) producing a patient-specific model of the dentition (set-ups), in particular made of plaster, of the teeth of an upper jaw and / or a lower jaw of a patient to be treated,
• 1d) selecting a rough rest from the rough rest library for each tooth of the patient to be treated,
• 1e) Forming a patient-specific adhesive surface on each raw support to produce a support with a patient-specific surface, in particular by arranging the raw support at a distance from the model of the dentition and filling the gap, which extends over the distance, with filling material and curing of the filling material,
• 1f) Selecting a bracket body from the bracket body library for each support to connect a bracket body to a support
• 1g) connecting a support to the associated bracket body to produce a bracket for each tooth of the patient to be treated.

• 2a) Bereitstellen eines Rohbracketkörpers mit einem Distanzabschnitt,
• 2b) Festlegen eines ersten Parameters zum Durchtrennen des Distanzabschnitts, einem Abstand einer entstehenden Schnittfläche des Distanzabschnitts vom Schlitz, um eine geeignete Höhe des Bracketkörpers festzulegen,
• 2c) Festlegen eines zweiten Parameters zum Durchtrennen des Distanzabschnitts, einem Schneidwinkel zu einer mesio-distalen-Achse, um einen geeigneten Torquewert des Bracketkörpers festzulegen,
• 2d) Festlegen eines dritten Parameters zum Durchtrennen des Distanzabschnitts, einem Schneidwinkel zu einer okklusal-gingivalen-Achse, um einen geeigneten Rotationswert des Bracketkörpers festzulegen,
• 2e) Durchtrennen des Distanzabschnitts entsprechend der drei festgelegten Parameter, insbesondere mittels einer Säge, wodurch ein Bracketkörper hergestellt ist.

The bracket bodies of the bracket body library are advantageously provided by:

• 2a) providing a raw bracket body with a spacer section,
• 2b) defining a first parameter for severing the spacer section, a distance of an emerging cut surface of the spacer section from the slot, in order to determine a suitable height of the bracket body,
• 2c) defining a second parameter for cutting through the spacing section, a cutting angle to a mesio-distal axis, in order to determine a suitable torque value of the bracket body,
• 2d) definition of a third parameter for cutting through the distance section, a cutting angle to an occlusal-gingival axis, in order to determine a suitable rotation value of the bracket body,
• 2e) cutting through the spacing section in accordance with the three defined parameters, in particular by means of a saw, whereby a bracket body is produced.

• 3a) Bereitstellen eines vorzugsweise ebenen Auflagenmaterialabschnitts,
• 3b) Bereitstellen einer Stanze mit mindestens einem Stanzstempel zum Ausstanzen mindestens einer Rohauflage aus dem Auflagenmaterialabschnitt,
• 3c) Ausstanzen mindestens einer Rohauflage aus dem Auflagenmaterialabschnitt mit Hilfe der Stanze.

The raw editions of the raw editions library are advantageously provided by:

• 3a) provision of a preferably flat layer of covering material,
• 3b) providing a punch with at least one punch for punching out at least one raw support from the support material section,
• 3c) punching out at least one raw support from the support material section using the punch.

The raw bracket bodies are preferably provided by an MIM or a selective laser melting method (selective laser melting method).

The overlay material section and / or the raw bracket bodies are advantageously provided from a biocompatible metal or a biocompatible alloy, in particular titanium, gold, silver or stainless steel or a cobalt-chromium alloy.

Each pad is advantageously connected to its associated bracket body by means of gluing or welding.

The formation of a patient-specific adhesive surface on a raw support in step 1e) is preferably carried out by filling a gap between the raw support and the associated tooth in the set-up with a filling material, in particular made of plastic, in order to enable the adhesive surface to be positively locked to the patient's clinical tooth .

At least two parameters, in particular the second and third, are advantageously varied in steps 2b) to 2d) in a predetermined interval with predetermined interval steps in order to create the bracket body library in which bracket bodies with the respective different parameter values are arranged.

In step 1a), in the raw edition library, prefabricated raw editions are provided in each case on a specific tooth, for example, in at least one embossing step preconfigured following the stamping out step, in particular prefabricated on a respective tooth of an upper jaw and / or a lower jaw.

The pre-assembly preferably includes adapting the buccal / lingual circumferential contour of the at least one raw support in order to adapt this circumferential contour of the raw support to a specific tooth size or shape.

The pre-assembly preferably includes a bending of selected sections of a raw support, in particular the bending of mesial and / or distal sections of a raw support, in order to form mesial and / or distal wing sections of the raw support which encompass the associated tooth at least in sections.

The pre-assembly advantageously includes bending an occlusal section of a raw support, which subsequently lies occlusally on the associated tooth.

The prefabrication preferably includes the formation of lingual / buccal protrusions with at least one raw support in order to adapt it to a lingual concave / convex structure of a particular tooth, for example.

Advantageously, the raw support selected in step 1d) is manually adapted to its associated tooth, wherein the adjustment may include adjusting the shape and / or the size of the raw support.

At least two different raw bracket bodies are advantageously provided, each of which is assigned to at least one specific tooth, in particular eight, i.e. a raw bracket body for each tooth (1 to 8), and in step 1b) the bracket body libraries are provided.

The brackets are preferably positioned in a malocclusion model of the patient on their associated tooth to be treated, and then a transfer tray is created.

The method is further characterized by the selection of a combination of bracket body and support from a library of prefabricated bracket bodies or supports, in particular with the connection of a bracket body, the spacer section of which has a cut surface which is arranged according to the three parameters, with the support, whose patient-specific surface is formed by a hardened filling material, which is formed by contact with the model of the dentition. The bracket body preferably has a cut surface spaced apart by a spacing section, which is produced by cutting through, in particular sawing. The spacing section spaces the cut surface from the slot of the bracket body and has a length which, as a first parameter, defines a suitable height of the bracket body. As a second parameter, the cut surface is arranged at a cutting angle to the mesio-distal axis and defines a suitable torque value of the bracket body. Furthermore, the cut surface is arranged as a third parameter at a cutting angle to the occlusal-gingival axis, which defines a suitable rotation value of the bracket body. The cut surface is therefore determined by the three parameters. By connecting the cut surface of the spacing section of the bracket body to the support, which in particular has a flat surface, preferably a constant material thickness, the arrangement of the bracket body for support is determined by the three parameters, and thus the arrangement of the slot in the bracket body is adapted for the three parameters set on the edition.

Detailed description of the invention

• Fig. 1 mehrere Ansichten einer Rohauflage für den Zahn 21,
• Fig. 2 mehrere Ansichten einer Rohauflage für den Zahn 23,
• Fig. 3 mehrere Ansichten einer Rohauflage für den Zahn 27,
• Fig. 4 mehrere Ansichten einer Rohauflage für den Zahn 35,
• Fig. 5 mehrere Ansichten einer Rohauflage für den Zahn 37,
• Fig. 6 mehrere Ansichten eines Rohbracketkörpers für den Zahn 1 des Oberkiefers (OK 1er),
• Fig. 6a mehrere Ansichten eines Bracketkörpers, hergestellt aus dem Rohbracketkörper der Fig.6,
• Fig. 7 mehrere Ansichten eines Rohbracketkörpers für den (Zahn 6 des Ober- oder Unterkiefers) OK oder UK 6er,
• Fig. 8 mehrere Ansichten eines Rohbracketkörpers für den OK oder UK 7er,
• Fig. 8a mehrere Ansichten eines Bracketkörpers, hergestellt aus dem Rohbracketkörper der Fig. 8,
• Fig. 9 eine perspektivische Ansicht eines Ziel-Set-Ups, wobei eine Rohauflage an einem Zahn angeordnet ist und ein Spalt zwischen beiden mit Kunststoff verfüllt ist,
• Fig. 10 eine perspektivische Ansicht eines Zahns, an den ein fertiges Bracket herangeführt wird,
• Fig. 11 eine Draufsicht auf eine Rohauflagenbibliothek und
• Fig. 12 eine Draufsicht auf eine Bracketkörperbibliothek.

Further features, details and advantages of the invention emerge from the claims and the following description of preferred embodiments and from the drawing. Show it:

• Fig. 1 several views of a rough rest for tooth 21,
• Fig. 2 several views of a rough rest for tooth 23,
• Fig. 3 several views of a rough rest for tooth 27,
• Fig. 4 several views of a rough rest for tooth 35,
• Fig. 5 several views of a rough rest for tooth 37,
• Fig. 6 several views of a raw bracket body for tooth 1 of the upper jaw (upper jaw 1),
• Fig. 6a several views of a bracket body, made from the raw bracket body of the Fig. 6 ,
• Fig. 7 several views of a raw bracket body for the (tooth 6 of the upper or lower jaw) upper or lower 6,
• Fig. 8 several views of a raw bracket body for the upper or lower 7s,
• Fig. 8a several views of a bracket body, made from the raw bracket body of the Fig. 8 ,
• Fig. 9 2 shows a perspective view of a target set-up, a raw support being arranged on a tooth and a gap between the two being filled with plastic,
• Fig. 10 1 shows a perspective view of a tooth to which a finished bracket is brought,
• Fig. 11 a top view of a raw edition library and
• Fig. 12 a plan view of a bracket body library.

First, a strip of overlay material (100m long, 5cm wide and 0.4mm thick) made of stainless steel and a punch with a punch are provided in order to use the punch to punch out raw sheets from the overlay material strip. The punch punches out several identical raw supports from an inserted covering material section of the covering material strip, the buccal / lingual circumferential contour thereof being adapted to the tooth for which the raw covering is being produced. Instead of a strip of overlay material, it is alternatively possible to use a sheet of overlay material.

In Fig. 1 the six side views and a perspective view of a raw support 5 for the tooth 21 which has been produced in this way are shown. The raw support 5 is flat and has a constant material thickness over the entire surface. The buccal / lingual circumferential contour 5U has almost the shape of a triangle, as a result of which the rough support 5 is well adapted to the tooth 21. The edges of the buccal / lingual circumferential contour 5U that were created during punching out were removed in a subsequent embossing step, resulting in the rounded side surfaces of this circumferential contour 5U.

Analogue shows the Fig. 2 a raw support 5 produced for the tooth 23 according to the same method, this raw support 5 being different from that of the tooth Fig. 1 only differs by the other shape of the buccal / lingual circumferential contour 5U.

Figure 3 shows the six side views and a perspective view of a raw support 5 for the tooth 27. The raw support 5 was made according to the same method as with reference to FIG Fig. 1 and 2nd described, produced, but two further bending steps were carried out. In a first bending step, a mesial 5m and a distal 5d wing section were formed by bending in a press with a suitable bending tool. In a second bending step, an occlusal section 50 of the raw support 5 was formed in a press with a suitable bending tool. In the inserted state, this occlusal section 50 lies on the tooth 27 occlusally in the patient.

Figure 4 shows the six side views and a perspective view of a raw support 5 for the tooth 35. The raw support 5 was made according to the same method as with reference to FIG Fig. 1 and 2nd described, produced, but in a further bending step a mesial 5m and a distal 5d wing section were formed.

Figure 5 shows the six side views and a perspective view of a raw support 5 for the tooth 37. The raw support 5 was made according to the same method as with reference to FIG Fig. 1 and 2nd described, manufactured, however, two further bending steps were carried out, as previously with reference to FIG Fig. 3 In a first bending step, a mesial 5m and a distal 5d wing section were formed in a press with a suitable bending tool by bending. In a second bending step, an occlusal section 50 of the raw support 5 was formed in a press with a suitable bending tool. In the inserted state, this occlusal section 50 lies on the tooth 37 occlusally in the patient.

The raw editions 5 produced in this way are sorted into a raw edition library 19, which in Fig. 11 is shown. The raw edition library 19 comprises 16 by 8 raw edition containers 21, which are arranged in a matrix. In the series OK _GZ and UK _GZ there are 16 raw support containers 21, ie one raw support container 21 is provided for each tooth of the upper jaw and the lower jaw. The raw support containers 21 are arranged analogously to the FDI tooth scheme in dentistry: starting from the 8 on the left over the 1 on the right to the 8 on the other half of the face. Accordingly, the raw support containers are designated 18 over 11 and 21 to 28, or 48 over 41 and 31 to 38. In each of these raw support containers 21 there are the raw supports 5 belonging to the respective tooth or adapted to them.

In the OK _GZ and UK _{GZ series} , the rough rest 5 are for the upper jaw and the lower jaw with large teeth. In the series OK _KZ and UK _{KZ there} are the rough supports 5 for the upper jaw and the lower jaw with small teeth. In the OK _OKZ and UK _{OKZ series} , the rough supports 5 with occlusal sections 5o are for the upper jaw and the lower jaw with small teeth, in the present case only for teeth 17, 18, 28, 27 and 34, 35, 37, 38, 44, 45, 47 and 48. In the OK _FGZ and UK _{FGZ series} , the rough supports 5 with wing sections 5m, 5d are for the upper jaw and the lower jaw with large teeth, in the present case only for teeth 14, 15, 16, 17, 18, 24 , 25, 26, 27, 28 and 34, 35, 36, 37, 38, 44, 45, 46, 47 and 48.

To create a patient-specific overlay, proceed as follows: An impression is taken of each patient's upper jaw and lower jaw and a plaster model is created using the same. The plaster models are articulated or arranged in an articulator, which reflects the relative position of the jaws to each other (malocclusion models). The target set-up is made from this malocclusion model and represents the planned situation at the end of the treatment. To create this, the teeth are cut out individually from the patient's malocclusion models and then reassembled in the target situation to be achieved, which results in the target set-up.

For the teeth to be treated, a suitable raw support 5 is now taken from the raw support library 19. The raw supports 5 that have been removed may be adapted further by hand to the associated teeth of the plaster model (target set-up), the shape and / or the size being adaptable, but also bending by hand. Subsequently, the raw supports 5 are each held on the associated tooth in the target set-up and a gap 27 between the tooth and the raw support 5 is filled with a filling material made of plastic, as in FIG Fig. 9 shown. In this way, the raw support 5 receives a patient-specific adhesive surface 3K and thereby becomes a support 3. This patient-specific adhesive surface 3K can later be positively placed on the patient's tooth and firmly connected to it with the aid of an adhesive.

The patient-specific supports 3 produced in this way are now each connected to a patient-specific bracket body 7, which is taken from a bracket body library 23, which is constructed analogously to the raw edition library, as described below.

Fig. 6 shows various views of a raw bracket body 9 for an OK 1er, this having a fixing section 9f, a spacing section 9d, a slot 11, a hook 13 and a wing 15. Fig. 6a shows the cut surface 10, which is arranged according to the three parameters.

Fig. 7 shows different views of a raw bracket body 9 for an upper jaw (upper jaw) or lower jaw (lower jaw) tooth 6 (6er), this having a fixing section 9f, a spacing section 9d, a slot 11, two hooks 13 and two wings 15.

Fig. 8 shows different views of a raw bracket body 9 in the form of a tube 17 for an upper jaw (upper jaw) or lower jaw (lower jaw) tooth 7 (7er), this also having a spacing section 9d.

The raw bracket bodies 9 were produced in a MIM process (alternatively in a selective laser melting process) and consist of a cobalt-chromium alloy (alternatively, for example, made of stainless steel). The hooks 13 and wings 15 each have a material taper at their end facing the slot 11, so that they still each e.g. can be bent by hand into a suitable angular position around the slot 11.

In order to have an optimal slot 11 available for treatment, the raw bracket bodies 9 are Figures 6 and 7 fixed with their fixing sections 9f to a carrier. Approx. 100 pieces can be attached to the carrier. The carrier with the raw bracket bodies 9 is immersed in a suitable liquid bath, in which the slot 11 of each raw bracket body 9 is cut using a wire erosion process. This can also be done over several passes (finishing). In this way, a very precise slot 11 is created with a low fault tolerance of the norm.

The raw bracket body of the Fig. 8 does not have a fixing section because it does not have a slot which has to be manufactured with high precision for the treatment.

After this step, the raw bracket body 9 of the Figures 6 to 8 fixed with its slot-side end in a corresponding negative form (to this end), alternatively fixing at the opposite end is possible. With the help of a saw, the spacing section 9d of the respective raw bracket body 9 is cut through at different angles. Three parameters can be set when cutting:
The first parameter is a distance of the resulting cut surface from the slot 11. The smaller this distance can be chosen, the less a patient feels the bracket.

The second parameter is an angle around the longitudinal axis of the slot 11 (mesio-distal axis). Depending on the deviation of the cutting angle from an average standard value, more or less torque is applied, see Fig. 6 to the nomenclature.

The third parameter is an angle around a perpendicular to the longitudinal axis of the raw bracket body 9 (occlusal-gingival axis). Depending on the deviation of the cutting angle from an average standard value, more or less rotation is applied, see Fig. 6 to the nomenclature.

These three parameters are now defined for a raw bracket body 9 and the spacing section 9d is cut accordingly with a saw, which results in a bracket body 7. Fig. 6a shows the raw bracket body 9 of the Fig. 6 , in which the distance section with respect to torque at 55 ° and with respect to rotation at 15 ° has been severed, as a result of which the bracket body 7 of the Fig. 6a results. Fig. 8a shows the raw bracket body 9 of the Fig. 8 , in which the distance section was cut with respect to torque at 20 ° and with respect to rotation at 15 °. Fig. 8a shows the cut surface 10 arranged according to the three parameters.

The bracket bodies 7 obtained in this way are sorted into bracket body containers 25 of a bracket body library 23 ( Fig. 12 ), whereby for each raw bracket body 9 the Figures 6 to 8 One bracket body library is available. In other words, the raw bracket body 9 has the Fig. 6 his own bracket body library, just like that of Fig. 7 and 8th .

Fig. 12 shows a bracket body library 23, which is constructed analogously to the raw edition library and is filled with bracket bodies 7. The bracket bodies 7 are subdivided in 1 ° steps with respect to rotation from -5 ° to + 5 ° and subdivided in 5 ° steps with respect to torque from 40 ° to 70 °. Of course, other interval limits and other interval steps can be used here, in particular also as a function of the raw bracket body 9, ie for the raw bracket body 9 Fig. 6 other interval limits and interval steps can be used than for the Fig. 7 . Together with the support 3, the bracket bodies 7 form a finished bracket 1.

The process for producing a patient-specific bracket is continued as follows: A patient-specific support 3 is already attached to the teeth to be treated in the set-up. For each support 3, a suitable bracket body 7 is now removed from the bracket body library and adhered to its respective support 3. The bracket bodies 7 are advantageously guided to the respective support 3 via a “mechanical finger” and then glued to them.

A 2-dim scan of the upper and / or lower model from the corresponding cranial or caudal direction (top view) is now carried out from the bracket set-up completed in this way in order to use the data to provide an appropriate wire arch a wire bending machine.

Then the plaster models are soaked in a water bath, whereby the supports with the bracket bodies adhered to them are loosened, which are subsequently welded to one another with the aid of a laser.

The brackets 1 produced in this way are placed on a plaster model of the patient (malocclusion model), see FIG. Fig. 10 , and fixed there to make a silicone transfer tray.

For teeth 21, 23, 27, 35 and 37 was in the Figures 1 to 5 each presented a raw edition 5. In general, it is possible to develop a rough support 5 that is specially adapted to this tooth for each tooth of the upper and / or lower jaw. Alternatively, it is possible to use a raw support 5 for several teeth, for example a raw support 5 for the teeth 32, 31, 41 and 42.

The raw edition library 19 according to Fig. 11 comprises 16 raw support containers 21 in each row, in which raw supports 5 are arranged for one tooth. From the tooth 8 (8s) on one side to the 8s on the other side, raw supports 5 are thus respectively provided. In an alternative embodiment, the raw support library 19 comprises 14 raw support containers 21 in each row, in which raw supports 5 are arranged for one tooth (from the 7th to the 7th). Raw supports 5 are thus respectively provided from the 7th on one side to the 7th on the other side.

In the context of the present invention, a matrix-like arrangement is understood to mean an arrangement in rows and columns.

The bracket body library 23 comprises bracket body containers 25 with bracket bodies 7 arranged therein. The bracket body containers 25 or the bracket bodies 7 arranged therein are sorted according to parameter values of the three parameters (distance from cutting surface to slot, angle of mesial-distal axis, angle of occlusal-gingival axis) . Generally it is possible to vary all three parameters in a bracket body library 23 of a raw bracket body 9. For example, it is possible to use the bracket body library 23 Fig. 12 with the same values for torque and rotation, but the third parameter (the distance between the cutting surface and the slot) is varied, for example enlarged or reduced by 1 mm. In this way there would be the bracket body library 23 Fig. 12 twice: once with a larger distance and once with a smaller distance, whereby a new bracket body library 23 is formed. The matrix-like arrangement of the Fig. 12 is thus expanded into the third dimension, in which the further parameter is varied. In practice, this general version is generally not necessary: since the distance between the cut surface and the slot should always be as small as possible, so that the bracket 1 produced disturbs the patient as little as possible, the bracket body library 23 can Fig. 12 sufficient that the distance between the cutting surface and the slot is as small as possible.

1. 1. Herstellung einer Rohauflagenbibliothek:
   • Bereitstellen eines vorzugsweise ebenen Auflagenmaterialabschnitts,
   • Bereitstellen einer Stanze mit mindestens einem Stanzstempel zum Ausstanzen von zahnspezifischen Rohauflagen aus dem Auflagenmaterialabschnitt,
   • Ausstanzen der zahnspezifischen Rohauflagen aus dem Auflagenmaterialabschnitt mit Hilfe der Stanze,
   • optionales Vorkonfektionieren der Rohauflagen.
2. 2. Herstellung einer Bracketkörperbibliothek:
   • Bereitstellen von Rohbracketkörpern mit einem Distanzabschnitt,
   • ggfls. Fertigen von hochpräzisen Schlitzen in den Rohbracketkörpern (bspw. mit Drahterosion),
   • Durchteilen der Distanzabschnitte mit ausgewählten Parameterwerten für die drei Parameter.
3. 3. Erstellen eines patientenspezifischen Ziel-Set-Ups, insbesondere aus Gips, vom zu behandelnden Oberkiefer und/oder Unterkiefer eines Patienten.
4. 4. Auswählen einer Rohauflage aus der Rohauflagenbibliothek für einen zu behandelnden Zahn des Patienten.
5. 5. Verfüllen eines Spalts zwischen der Rohauflage und dem zugehörigen Zahn im Ziel-Set-Up mit einem Füllmaterial, insbesondere aus Kunststoff, um eine zahnspezifische Klebefläche für die Auflage herzustellen, die einen Formschluss mit dem klinischen Zahn des Patienten ermöglicht.
6. 6. Auswählen eines Bracketkörpers aus der Bracketkörperbibliothek für jede Auflage.
7. 7. Fixieren des Bracketkörpers an der Auflage, um das patientenspezifische Bracket zu bilden.

An advantageous method for producing a patient-specific bracket with a patient-specific support and a patient-specific bracket body can thus be divided into the following steps:

1. 1. Production of a raw edition library:
   • Providing a preferably flat layer of covering material,
   • Providing a punch with at least one punch for punching out tooth-specific raw supports from the overlay material section,
   • Punching out the tooth-specific raw overlays from the overlay material section using the punch,
   • optional pre-assembly of the raw supports.
2. 2. Production of a bracket body library:
   • Providing raw bracket bodies with a spacing section,
   • if necessary Manufacture of high-precision slots in the raw bracket bodies (e.g. with wire erosion),
   • Divide the distance sections with selected parameter values for the three parameters.
3. 3. Creation of a patient-specific target set-up, in particular made of plaster, of the upper jaw and / or lower jaw of a patient to be treated.
4. 4. Select a rough rest from the rough rest library for a patient's tooth to be treated.
5. 5. Filling a gap between the raw rest and the associated tooth in the target set-up with a filling material, in particular made of plastic, in order to produce a tooth-specific adhesive surface for the rest, which enables a positive fit with the clinical tooth of the patient.
6. 6. Select a bracket body from the bracket body library for each edition.
7. 7. Fix the bracket body to the support to form the patient-specific bracket.

However, the process steps do not have to be carried out in this order. It is possible, for example, to alternatively first connect the raw supports 5 to their associated bracket bodies 7 and only then form the adhesive surface 3K.

Reference list

1

Bracket

3rd

Edition

3K

Adhesive surface of the pad

5

Raw edition

5 m

Mesial (wing) section of a rough support

5d

Distal (wing) section of a rough support

5o

Occlusal section of a rough rest

5U

buccal / lingual circumferential contour

7

Bracket body

9

Raw bracket body

9d

Spacer section of the raw bracket body

9f

Fixing section of the raw bracket body

10th

Cutting surface

11

slot

13

hook

15

wing

17th

tube

19th

Raw edition library

21

Raw support container

23

Bracket body library

25th

Bracket body container

27

gap

Claims (16)

1. Process for the production of at least one patient-specific, modularly constructed bracket (1) having a pad (3) and a bracket body (7), the process comprising the steps:

   a) providing a raw pad library (19) of raw pads (5), wherein same raw pads (5) are filled into raw pad containers (21) of the raw pad library (19),

   b) providing at least one bracket body library (23) of bracket bodies (7), wherein same bracket bodies (7) are filled into bracket body containers (25) of the bracket body library (23),

   c) generating a patient-specific set-up, in particular of gypsum, of teeth to be treated of an upper jaw and/or a lower jaw of a patient,

   d) selecting a raw pad (5) from the raw pad library (19) for each tooth to be treated of the patient,

   e) forming a patient-specific bonding surface (3K) at each raw pad (5), whereby a pad (3) is formed,

   f) selecting a bracket body (7) from the bracket body library (23) for each pad (3) for the respective connection to the pad (3),

   g) connecting each pad (3) to the corresponding bracket body (7), whereby a bracket (1) for each tooth to be treated of the patient is formed.
2. Process according to claim 1, characterized in that the bracket bodies (7) of the bracket body library (23) are provided by

   a) providing a raw bracket body (9) having a distance section (9d),

   b) defining a first parameter for cutting through the distance section (9d), which parameter is a distance of a resulting cut surface of the distance section (9d) from the slot (11), in order to define a suitable height of the bracket body (7),

   c) defining a second parameter for cutting through the distance section (9d), which parameter is a cutting angle to a mesio-distal axis, in order to define a suitable torque value of the bracket body (7),

   d) defining a third parameter for cutting through the distance section (9d), which parameter is a cutting angle to an occlusal-gingival axis, in order to define a suitable rotation value of the bracket body (7),

   e) cutting through the distance section (9d) according to the three defined parameters, in particular by means of a saw, whereby a bracket body (7) is produced.
3. Process according to claim 1 or 2, characterized in that the raw pads (5) of the raw pad library (19) are provided by

   a) providing a preferably plane pad material section,

   b) providing a punch having at least one punching die to punch out at least one raw pad (5) from the pad material section,

   c) punching out at least one raw pad (5) from the pad material section by means of the punch.
4. Process according to one of the preceding claims, characterized in that the raw bracket bodies (9) are provided by a MIM process or a selective laser melting process.
5. Process according to one of the preceding claims, characterized in that the pad material section and/or the raw bracket bodies (9) is/are provided from a biocompatible metal or a biocompatible alloy, in particular titanium, gold, silver, or non-corrosive steel, or a cobalt-chromium alloy.
6. Process according to one of the preceding claims, characterized in that connecting each pad (3) to its corresponding bracket body (7) occurs by gluing or welding.
7. Process according to one of the preceding claims, characterized in that forming of a patient-specific bonding surface (3K) at a raw pad (5) in step 1e) occurs by backfilling a gap (27) between the raw pad (5) and the corresponding tooth within the set-up with a filling material that is in particular from plastic, in order to allow for a form fit of the bonding surface (3K) to the clinical tooth of the patient.
8. Process according to one of the preceding claims, characterized in that at least two parameters, in particular the second and the third, in the steps 2b) to 2d) are each varied within a pre-determined interval having pre-determined interval steps in order to generate the bracket body library (23) within which bracket bodies (7) having the respective different parameter values are arranged.
9. Process according to one of the preceding claims, characterized in that in step 1a), raw pads (5), each pre-customized to a specific tooth, are provided within the raw pad library (19), e.g. raw pads (5) that are pre-customized in at least one embossing step following the punching out and that are pre-customized to a respective tooth of an upper jaw and/or of a lower jaw.
10. Process according to claim 9, characterized in that the pre-customizing encompasses fitting of the buccal/lingual perimeter contour (5U) of the at least one raw pad (5) in order to fit said perimeter contour (5U) of the raw pad (5) to a specific size or form of a tooth.
11. Process according to claim 9 or 10, characterized in that the pre-customizing encompasses bending of selected sections of a raw pad (5), in particular the bending of mesial and/or distal sections of a raw pad (5), in order to form mesial and/or distal wing sections (5m, 5d) of the raw pad (5) that at least sectionally encompass the corresponding tooth.
12. Process according to one of claims 9 to 11, characterized in that the pre-customizing encompasses bending of an occlusal section of a raw pad (5), which occlusal section subsequently occlusally rests on the corresponding tooth.
13. Process according to one of claims 9 to 12, characterized in that the pre-customizing encompasses forming of lingual/buccal protrusions on at least one raw pad (5) in order to e.g. fit it to a lingual concave/convex structure of a specific tooth.
14. Process according to one of the preceding claims, characterized by manually fitting the raw pad (5) selected in step 1d) to its corresponding tooth, wherein the fitting encompasses fitting of the form and/or of the size of the raw pad (5).
15. Process according to one of the preceding claims, characterized in that at least two different raw bracket bodies (9) are provided that are each assigned to at least one specific tooth, in particular eight, namely one raw bracket body (9) for each tooth (1^st to 8^th), and in step 1b) the bracket body libraries (23) thereof are provided.
16. Process according to one of the preceding claims, characterized in that the brackets (1) within a malocclusion model of the patient are each positioned on their corresponding tooth to be treated, and then a transfer tray is produced within which the brackets (1) are arranged in their relative places and positions according to the malocclusion.

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